It is an ayurvedic parasurgical treatment which involves management of Anorectal disorders for treating haemorrhoids, fistula-in-ano, Anal Fissure and Pilonidal Sinus. Pilonoidal Sinus (PNS) is a condition that occurs mainly in men, in young adults and in those who does a sitting job wherein a small hole or tunnel develops on the skin that gets filled with fluid or pus and forms an abscess or a cyst. This occurs in the cleft at the top of buttocks and the cyst mainly contains a foreign body like some debris, hair or dirt causing infection and severe pain, oozing out blood, pus and a bad odour. Anal fissure is a condition which is characterised by a small crack in the skin in the anal lining causing bleeding and severe pain during and after bowel movements. This condition happens due to hurting bowel movements, or during childbirth, or due to constipation. Anal fissure can occur in people of any age and usually in not a serious condition. Fistula-in-ano is a chronic condition where a tunnel forms connecting the epithelialized surface of the anal canal and the perianal skin. It mainly occurs in people with an anal abscesses history and forms when the abscesses or cyst has not healed completely. It can be very painful and irritating. The therapy roots from Ayurveda by Charak, Sushruta and Vagbhata and its efficacy was established again by BHU’s Shalya Tantra Department. The treatment is absolutely effective, very safe and affordable. The technique is practised widely in India as well as other countries. The technique basically uses a specially prepared thread to treat the diseases.
Kshar Sutra is first prepared by coating a surgical linen thread gauge number 20 with Snuhi latex (Euphorbia neriifolia) for 11 times, Snuhi latex and Apamarga Kshara (Achyranthes aspera) for 7 times and Snuhi latex and Haridra churna (turmeric powder) for 3 times. Kshara Sutra in Fistula-in-ano patients is applied by anaesthetizing the person and passing a malleable probe with the Kshara Sutra in its groove through the external opening of the fistula to the internal one and carefully taking the probe out with the Kshara Sutra intact. Then both ends of the Khara Sutra are tied together and replace by the new one a week later. This way the tract is eventually cut and healed removing unhealthy tissue, controlling microbial infection and facilitating drainage of pus in the tract to aid in healing. The therapy in Pilonidal Sinus is done by applying the same method as the previous one where the Kshara Sutra is passed through the sinus’ external opening to the skin and then tying its ends together and replacing it a week later. Kshara Sutra in Haemorrhoids is done by first sedating the patient, thereafter pile mass is brought out of the anal orifice using forceps, then given an incision at the mucocutaneous joint, slightly pulling the pile mass and transfixing it with Kshara Sutra at its base, finally replacing the ligated pile mass into the rectum with Yastimadhu taila or ghrita. In Haemorrhoids’ therapy the blood vessels are chemically cauterized and mechanically strangulated, then pile mass tissue’s local gangrene is done causing necrosis and detriment of unhealthy tissue that slough of the mass in 5-7 days and finally completely healing the wound in 10-15 days.
Anal Fissures, haemorrhoids, Fistula-in-ano and other ano rectal diseases occur mostly in people who do mainly sitting jobs, in young adults as well as in infants and children because constipation is a common problem in all age groups
Pregnant women, people with carcinoma in the rectum, hepatitis and leprosy are not eligible for the treatment.
There is no side effect due to the Kshar Sutra treatment except a very mild post procedural pain. The therapy comes as a very safe and a sure one to remove the pile mass, or the anal fissure or the sinus problem. The patients who opt for this ayurvedic treatment feel much happier and satisfied getting that extra mass out and healing that painful fissure. Surgical complications that occur in non-ayurvedic treatments involve stenosis, stricture and incontinence which do not happen in case of this therapy. Even the anaesthesia does not have any side effect as it is usually a local one.
Patients must take only liquid diet before six hours of the surgery and semi-solid diet after 3-4 hours. From the following day patients are advised to take warm Pancha Valkal Kwath sitz bath at least thrice for at least 3 weeks. Triphala Guggulu of 500 mg and Haritaki Churna of 5-10 mg at bed time with luke-warm water, for another two weeks, Jatyadi Tail Matrabasti of 10 ml is prescribed to the patient for twice a day and some analgesics are also given in case of any pain. Patients are strictly advised to stay active by walking and doing other movements while the treatment is on-going, take normal fibre enriched food and mild laxatives daily to avoid constipation and have a clear bowel on a regular basis, avoid long distance driving and travelling and also too long sitting or standing when the treatment is on.
One of the many benefits of Kahar Sutra therapy is that patients recover in just 3-5 days after the complete treatment is over, requiring very little bed rest, just 5-6 hours of stay at hospital taking only 30-45 mins for the procedure to get done.
This treatment is very cost effective and the consultation fee falls in the range of just Rs. 200 to Rs. 300 with the actual treatment for only Rs. 1500 to Rs. 2,000
The results are permanent and there is extremely little chance for the condition to recur.
Alternative treatment are usually started with home remedies like consumption of more fibre rich food, more water intake so that bowel movement are smooth and do not strain your anal and rectal muscles. But if the condition worsens tougher medications are prescribed like Calcium channel blocking drugs (CCBs), nitroglycerine and botulinum toxin which do come with their share of side effects. With the help of these treatments, healing is usually temporary and have high chances of recurrence. This calls for surgery which is sure to cause several side effects like stenosis and incontinence (stool leakage).